Background/Purpose:  Spondyloarthropathies include a group of disease which have similar clinical, radiographic and genetic features. Uveitis, psoriasis (PsO) and inflammatory bowel disease (IBD) are common extra-articular manifestations (EAMs) in spondyloarthritis and an important part of the ASAS classification criteria for axial and peripheral spondyloarthritis which has an influence on treatment choices. The aim of this study is to compare the burden of disease and clinical features in the patients with axial spondyloarthritis (axSpA) with and without EAMs.

Methods:  Adult patients from Erciyes SpA cohort who met ASAS classification criteria for axSpA were included. Patients were assigned into two groups according to having EAMs (uveitis and/or IBD and/or PsO, all were proven by the related specialists). Radiographic axSpA was defined on the basis of presence of at least bilateral grade 2 sacroiliitis according to modified New York criteria, decided by the consensus of three rheumatologists. Patients’ demographic and clinical data including symptom duration, VAS-pain, patient’s and physician’s global assessment, BASDAI were recorded. Short form-36 (physical and mental components, SF-36 PCS/MCS), health assessment questionnaire (HAQ) and ankylosing spondylitis quality of life questionnaire (ASQoL) were used to assess QoL and disability and hospital anxiety and depression scale (HADS) for psychological status. Anthropometric measurements included cervical rotation, tragus-to-wall distance (TWD), chest expansion, lumbar lateral flexion and Schober’s test.

Results: A total of 591 patients with axSpA were included, 124 patients (%21) had EAMs (EAM +ve) and 467 patients (%79) did not have EAMs (EAM -ve). Demographic data and all anthropometric measurements were similar between EAM +ve and EAM -ve patients, except for TWD which was higher in EAM +ve patients (whole axSpA, p=0.034 and r-axSpA, p=0.002). EAM +ve patients had higher frequency of HLA B27 and peripheral arthritis than EAM –ve patients in the whole axSpA (p=0.031 and p=0.003, respectively) and r-axSpA (p=0.036 and p=0.001, respectively) groups.

Conclusion: EAMs positive and negative patients with r-axSpA differs in terms of HLA B27 and peripheral arthritis, however subgroups of patients with nr-axSpA and r-axSpA with or without EAMs have similar burden of disease.